P4428Association between cigarette smoking and testosterone levels in men with erectile dysfunction

Abstract

Background: Testosterone deficiency and smoking are both associated with erectile dysfunction (ED) and cardiovascular (CV) mortality risk. Purpose: Aim of this study is to investigate the association between smoking and testosterone levels in patients with ED, a population with particularly high CV risk. Methods: We measured total testosterone (TT) levels in 761 ED patients (mean age 56±7 years) without manifest cardiovascular/atherosclerotic disease. Within this population, there were 378 smokers, 118 non-smokers, and 265 ex-smokers. Ex-smokers were included if they had stopped smoking at least 6 months earlier and had smoked a minimum of six cigarettes a day while actively smoking. Results: Compared to smokers, never-smokers and ex-smokers were older (overall P<0.01). The three groups had similar prevalence of hypertension, dyslipidemia and type II diabetes. Current smokers had significantly higher TT compared to ex-smokers and never-smokers even after adjustment for age (overall P<0.01, left figure). However, within smokers TT levels were inversely correlated to the amount of tobacco exposure (overall P<0.01, right figure). Smoking was an independent influencing factor for the levels of TT in multivariate logistic regression models before and after adjusting for age, body mass index, fasting blood glucose, triglycerides and C-reactive protein (OR = 1.52, 95% CI: 1.27- 2.36, P<0.001). Conclusions: Smoking can lead to an increase in testosterone levels, but this can decrease with chronic exposure to tobacco by long-term smoking. Further studies should be conducted to evaluate how much of the unfavorable of smoking on CV outcomes are mediated by their effect on testosterone levels.